| NPI | 1275577843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: DE C10004311) |
| Additional Taxonomies | 174400000X Specialist (Licence: DE C10004311) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2025-03-31 |