| NPI | 1801945514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: FL ME128676) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MS 27722) |
| 208200000X Plastic Surgery (Licence: TN 64606) | |
| 208200000X Plastic Surgery (Licence: VA 0101271594) | |
| 208200000X Plastic Surgery (Licence: GA 76383) | |
| 208200000X Plastic Surgery (Licence: CA A137007) | |
| 208200000X Plastic Surgery (Licence: CO DR.0058162) | |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2022-06-03 |