| NPI | 1306913710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: CO 0054988) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CA A68283) |
| 208200000X Plastic Surgery (Licence: CA A068283) | |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2021-11-29 |