| NPI | 1700866985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: FL ME77501) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: FL ME77501) |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2026-04-30 |