| NPI | 1407381239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: OK 39414) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL 6699-851) |
| Enumeration Date | 2017-04-30 |
| Last Update Date | 2025-08-19 |