| NPI | 1376988493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: TX 573664) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: TX S0919) |
| Enumeration Date | 2013-05-02 |
| Last Update Date | 2023-01-03 |