| NPI | 1356344626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: AZ 31346) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: WI 101550) |
| 208200000X Plastic Surgery (Licence: ID M10264) | |
| 208200000X Plastic Surgery (Licence: NH 22884) | |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2024-06-20 |