| NPI | 1457309288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: FL ME59386) |
| Additional Taxonomies | 208800000X Urology (Licence: FL me0059386) |
| 208200000X Plastic Surgery (Licence: FL ME59386) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2024-06-10 |