| NPI | 1346980893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MN 74700) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MN 32904) |
| Enumeration Date | 2022-03-31 |
| Last Update Date | 2023-07-14 |