| NPI | 1275108268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MN 72157) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MN 31720) |
| Enumeration Date | 2021-05-23 |
| Last Update Date | 2022-08-25 |