| NPI | 1669492690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 9401342) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: NC 9401342) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2023-12-18 |