| NPI | 1356381719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: GA 98185) |
| Additional Taxonomies | 174400000X Specialist (Licence: DE C10005572) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2024-02-07 |