| NPI | 1326003179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: TN 41308) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: NC 9601744) |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2020-02-06 |