| NPI | 1396010435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MN 66563) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: FL 157977) |
| Enumeration Date | 2012-03-21 |
| Last Update Date | 2023-12-10 |