| NPI | 1326334616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: CO DR.0063432) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: NY 281846) |
| 208600000X Surgery (Licence: NY 281846) | |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2021-07-10 |