| NPI | 1295098168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: TX R7650) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: OR MD230996) |
| Enumeration Date | 2012-06-16 |
| Last Update Date | 2026-08-11 |