| NPI | 1457543696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: PA MD454410) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: LA MD205377) |
| Enumeration Date | 2007-08-13 |
| Last Update Date | 2020-08-31 |