| NPI | 1588127146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NV 27738) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: NV 27738) |
| Enumeration Date | 2019-04-10 |
| Last Update Date | 2025-07-29 |