| NPI | 1437475779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NC 2019-00945) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2019-00945) |
| Enumeration Date | 2010-04-12 |
| Last Update Date | 2024-05-21 |