| NPI | 1184944506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: FL ME127272) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL ME127272) |
| Enumeration Date | 2010-06-08 |
| Last Update Date | 2026-01-23 |