| NPI | 1154442432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NH 23047) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NY 283380) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2023-07-28 |