| NPI | 1851550867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: FL ME155748) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: OR MD173983) |
| 208200000X Plastic Surgery (Licence: WI 71292) | |
| 208200000X Plastic Surgery (Licence: PA MD448418) | |
| 208600000X Surgery (Licence: PA MT192405) | |
| Enumeration Date | 2008-06-04 |
| Last Update Date | 2023-10-11 |