| NPI | 1265435382 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: AL 00018171) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: AL 00018171) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2019-03-04 |