| NPI | 1275593725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: OH 35-04-0407) |
| Additional Taxonomies | 208D00000X General Practice (Licence: OH 35040407) |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2015-05-07 |