| NPI | 1548385248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: CO DR43489) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MA 238442) |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CO 43489) | |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2022-11-02 |