| NPI | 1225232747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NC 2013-01500) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2013-01500) |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2024-07-15 |