| NPI | 1013934538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: PA MD463261) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: VA 010196841) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2020-10-02 |