| NPI | 1093343212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MN 70145) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MN 30735) |
| Enumeration Date | 2020-04-01 |
| Last Update Date | 2021-09-10 |