| NPI | 1033146691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: FL ME72028) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: FL ME72028) |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2011-02-25 |