| NPI | 1821432535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: AZ 54385) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MD D94674) |
| Enumeration Date | 2013-04-24 |
| Last Update Date | 2023-08-28 |