| NPI | 1073643573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MO R8A10) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: KS 0429782) |
| 208200000X Plastic Surgery (Licence: AR C5716) | |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2007-07-08 |