| NPI | 1093158503 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: UT 11262380-1205) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: DE C1-0026170) |
| Enumeration Date | 2013-04-15 |
| Last Update Date | 2023-08-24 |