| NPI | 1326090259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: KS 0422406) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MO 105608) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2017-08-04 |