| NPI | 1194187765 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: AR E-16039) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: AR E-16039) |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2023-07-27 |