| NPI | 1073158556 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MA 1014484) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MA 283297) |
| Enumeration Date | 2019-11-08 |
| Last Update Date | 2023-11-06 |