| NPI | 1992951883 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: SC 31158)  | 
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: SC 31158)  | 
| 208600000X Surgery (Licence: SC LL31158)  | |
| 208600000X Surgery (Licence: SC 31158)  | |
| Enumeration Date | 2008-08-12 | 
| Last Update Date | 2023-10-30 |