| NPI | 1649284415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: SD 15175) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: NE 19157) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2024-05-24 |