| NPI | 1184361073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MN 74687) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MN 32507) |
| Enumeration Date | 2022-05-12 |
| Last Update Date | 2023-07-14 |