| NPI | 1871280164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MN 78230) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MN 33688) |
| Enumeration Date | 2023-04-18 |
| Last Update Date | 2024-10-15 |