| NPI | 1275673824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: CA A85022) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A85022) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2013-07-16 |