| NPI | 1184629545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: CT 029132) |
| Additional Taxonomies | 174400000X Specialist (Licence: CT 029132) |
| Enumeration Date | 2005-06-14 |
| Last Update Date | 2014-03-03 |