| NPI | 1326536061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: TX V0857) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX BP1-0063888) |
| Enumeration Date | 2018-04-27 |
| Last Update Date | 2024-06-17 |