| NPI | 1730210303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: CT 051774) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: ID M-14559) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2023-04-19 |