| NPI | 1033347141 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2016-01989) |
| Additional Taxonomies | 208600000X Surgery (Licence: RI LP01786) |
| 208200000X Plastic Surgery (Licence: RI LP01786) | |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2016-12-07 |