| NPI | 1275889917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: LA 307070) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: LA GETP.201331) |
| Enumeration Date | 2012-07-31 |
| Last Update Date | 2018-10-09 |