| NPI | 1598927824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: OH 35.134010) |
| Additional Taxonomies | 208600000X Surgery (Licence: NE 25622) |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2021-03-01 |