| NPI | 1356416994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NV 8578) |
| Additional Taxonomies | 174400000X Specialist (Licence: NV 8578) |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NV 8578) | |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2024-06-27 |