| NPI | 1629050174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: GA 24290) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: GA 024290) |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: SC 13549) | |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2026-05-21 |