| NPI | 1922455484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MD D0100887) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: DE C1-0027208) |
| Enumeration Date | 2016-05-15 |
| Last Update Date | 2024-08-01 |