| NPI | 1144376724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: FL ME154592) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: GA 064693) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2022-02-25 |