| NPI | 1508923582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: VA 0101233678) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: DC MD33575) |
| 174400000X Specialist (Licence: VA 0101233678) | |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2023-03-09 |