| NPI | 1851783583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: IA MD-43685) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CA 134910) |
| Enumeration Date | 2015-03-04 |
| Last Update Date | 2022-07-21 |