| NPI | 1285677385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: OH 35053321) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: IN 01034879A) |
| 208200000X Plastic Surgery (Licence: KY 22201) | |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2023-09-26 |