| NPI | 1225013790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: CA A54333) |
| Additional Taxonomies | 170100000X Medical Genetics, Ph.D. Medical Genetics (Licence: CA a54333) |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2014-03-10 |