| NPI | 1285016196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: AK 209060) |
| Additional Taxonomies | 208600000X Surgery (Licence: AK 209060) |
| 208600000X Surgery (Licence: WA ML60565507) | |
| Enumeration Date | 2015-06-27 |
| Last Update Date | 2023-10-25 |