| NPI | 1013169085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: CA A88033) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A88033) |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2022-02-16 |