| NPI | 1013476183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: OK 45439) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A180496) |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2025-05-10 |