| NPI | 1134302433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: ID M-17141) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MO 2012011130) |
| Enumeration Date | 2007-12-10 |
| Last Update Date | 2023-06-30 |