| NPI | 1265926851 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: KS 04-51237) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: SC LL52749) |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2025-07-16 |