| NPI | 1043530819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MO 2022027107) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036.130308) |
| 208200000X Plastic Surgery (Licence: CA A129361) | |
| Enumeration Date | 2010-06-03 |
| Last Update Date | 2024-05-20 |