| NPI | 1134381684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: WA MD61079655) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: OK 34322) |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2024-01-09 |