| NPI | 1053387399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: TX L2679) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX L2679) |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2014-03-06 |