| NPI | 1861517625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NC 2024-00716) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MD D61125) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2024-08-01 |