| NPI | 1487898391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: AZ 76376) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CA A87082) |
| Enumeration Date | 2009-04-22 |
| Last Update Date | 2025-10-27 |