| NPI | 1699933093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: GA 79975) |
| Additional Taxonomies | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: MA 270153) |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2024-02-07 |