| NPI | 1982109336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MN 65993) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MN 29301) |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2020-08-27 |