| NPI | 1013924752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: AZ 52645) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: AR R4487) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2016-10-29 |