| NPI | 1245204759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: WI 49054-020) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: VA 0101052917) |
| 208200000X Plastic Surgery (Licence: WV 20893) | |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2023-03-07 |