| NPI | 1184717076 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: OH 051155) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: WI 4593) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2024-08-16 |