| NPI | 1124062765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: CA A94530) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CA A94531) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2009-12-19 |