| NPI | 1306003819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MI 4301080398) |
| Additional Taxonomies | 174400000X Specialist (Licence: MI 4301080398) |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2019-03-01 |