| NPI | 1275540692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: SC MD87844) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CO 43027) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2023-05-22 |