| NPI | 1821831298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MN 80724) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MN 34386) |
| Enumeration Date | 2024-06-14 |
| Last Update Date | 2025-08-21 |