| NPI | 1093036386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NY 302544) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: AZ 57962) |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2020-02-13 |