| NPI | 1932554763 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: CA A177920) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: TX BP10057076) |
| Enumeration Date | 2016-04-29 |
| Last Update Date | 2023-09-18 |