| NPI | 1538350236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: LA MD.026419) |
| Additional Taxonomies | 208600000X Surgery (Licence: LA MD.026419) |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: LA MD 026419) | |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2021-10-06 |