| NPI | 1013027374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: KS 0423923) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MO MD100181) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2008-07-15 |