| NPI | 1700011756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: OK 31056) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: TX BP1-0034952) |
| 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: TX Q0972) | |
| Enumeration Date | 2009-05-20 |
| Last Update Date | 2021-09-14 |