| NPI | 1164441184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: CO 42032) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CO 42032) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2015-08-25 |