| NPI | 1598827933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MA 235037) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 225069) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2020-01-29 |