| NPI | 1851737233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: OH 35143037) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MI 4301117403) |
| Enumeration Date | 2013-05-13 |
| Last Update Date | 2021-11-10 |