| NPI | 1639278666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: KS 0423967) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MO 103151) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2021-11-10 |