| NPI | 1548429954 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NV 20150) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: GA 86853) |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2022-12-30 |