| NPI | 1447454186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: WI 71672) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: OH 35.131669) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2021-11-24 |