| NPI | 1982050340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MI 4301509078) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: UT 12706106-1205) |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: IN 11018869A) | |
| Enumeration Date | 2016-05-04 |
| Last Update Date | 2023-08-08 |