| NPI | 1750386066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: PA MD483668) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: GA 052405) |
| 208200000X Plastic Surgery (Licence: TN MD0000020999) | |
| 208200000X Plastic Surgery (Licence: MS 23882) | |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2024-02-09 |