| NPI | 1497835946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MO 2020005824) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: MO 2020005824) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2024-04-25 |