| NPI | 1023245578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: AZ 66380) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ 66380) |
| Enumeration Date | 2009-06-11 |
| Last Update Date | 2025-03-12 |