| NPI | 1952326365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: SC 22776) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: SC 22776) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2020-11-24 |