| NPI | 1043227622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: TX N3126) |
| Additional Taxonomies | 202K00000X Phlebology (Licence: TX N3126) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2025-09-12 |