| NPI | 1245324243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NC 9401216) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: NC 9401216) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2024-03-22 |