| NPI | 1033373527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: GA 77012) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: TN MD48367) |
| 208600000X Surgery (Licence: TN md48367) | |
| Enumeration Date | 2008-07-14 |
| Last Update Date | 2022-09-11 |