| NPI | 1649206731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: OH 35060709H) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: KY 35534) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2022-11-29 |