| NPI | 1447205257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: VA 0101245330) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MA 225477) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2023-03-07 |