| NPI | 1801933312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: VA 0101242102) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MD D82897) |
| 208600000X Surgery (Licence: VA 0101242102) | |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2023-11-18 |