| NPI | 1942380167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: GA 85769) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: FL 58213) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2022-09-20 |