| NPI | 1639265416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NY 143947) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 143947) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2023-11-09 |