| NPI | 1164620720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: IN 01077425A) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT191327) |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2016-09-08 |