| NPI | 1538336938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MN 61312) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MN 109206) |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NY 262065) | |
| Enumeration Date | 2008-05-14 |
| Last Update Date | 2023-10-10 |