| NPI | 1407992662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: FL ME71688) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: FL ME71688) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2022-01-04 |