| NPI | 1245254838 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: CA C153635) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: FL ME84444) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2024-07-12 |