| NPI | 1326278995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NJ 25MA12115400) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CA A110517) |
| Enumeration Date | 2009-07-17 |
| Last Update Date | 2024-07-24 |