| NPI | 1760578579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NH 1567) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MA 262908) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2022-05-25 |