| NPI | 1467611566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: TX P8152) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: AL MD.31528) |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2023-03-29 |