| NPI | 1659322501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MD D0053034) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: DE C1-0007261) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2022-09-06 |