| NPI | 1356506968 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: IN 01085600A)  | 
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: AZ 60248)  | 
| Enumeration Date | 2008-07-23 | 
| Last Update Date | 2024-04-17 |