| NPI | 1992993885 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: VA 0101257764) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: VA 0101257764) |
| 208200000X Plastic Surgery (Licence: VA 0101257764) | |
| Enumeration Date | 2007-10-04 |
| Last Update Date | 2024-01-26 |