| NPI | 1891773545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MN 26207) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MS 21725) |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2018-10-03 |