| NPI | 1508623810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MN 77682) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: TX BP10083398) |
| Enumeration Date | 2024-03-04 |
| Last Update Date | 2024-08-20 |