| NPI | 1205237013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: IN 01049794A) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: VA ME120550) |
| Enumeration Date | 2014-09-11 |
| Last Update Date | 2023-03-07 |