| NPI | 1184724718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MS 16268) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MS 16268) |
| Enumeration Date | 2006-09-24 |
| Last Update Date | 2025-02-06 |