| NPI | 1902945447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: CO 50232) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: IN 01063040A) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2021-06-17 |