| NPI | 1477506798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: OH 35.142873) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MD D53606) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2023-07-17 |