| NPI | 1346402948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: OH 35.127102) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: OH 35.127102) |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: KY TP600) | |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2022-05-03 |