| NPI | 1912173147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: TN 58363) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: GA 65774) |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2023-07-21 |