| NPI | 1184786121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: PA MD035909E) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: GA 44753) |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2021-03-28 |