| NPI | 1225011596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MI 4301057593) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: IN 01096238A) |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2025-06-17 |