| NPI | 1447455399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: TN MD0000049546) |
| Additional Taxonomies | 208600000X Surgery (Licence: TN MD0000049546) |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2023-03-31 |