| NPI | 1558441246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NE 23875) |
| Additional Taxonomies | 208600000X Surgery (Licence: NE 23875) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2023-08-15 |