| NPI | 1497821581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NM 97-272) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NM 97-272) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2024-11-07 |