| NPI | 1285898247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: CA A116784) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: GA 80567) |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2022-08-02 |