| NPI | 1205157658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: CO DR.0071483) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: SC 40951) |
| 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: SC 40951) | |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2024-01-12 |