| NPI | 1588083414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MD d91664) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: SD 12194) |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2021-07-26 |