| NPI | 1225094428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: CT 69491) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MA 210713) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2021-10-04 |