| NPI | 1245371954 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MD D31354) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: VA 0101037411) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2008-06-10 |