| NPI | 1366543860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NV 9377) |
| Additional Taxonomies | 174400000X Specialist (Licence: NV 9377) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2021-10-01 |