| NPI | 1356409866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: FL ME98407) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: NY MD112279) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2023-03-07 |