| NPI | 1316246788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NC 2014-01807) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2014-01807) |
| Enumeration Date | 2011-03-24 |
| Last Update Date | 2023-12-18 |