| NPI | 1346570272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: AR C-4058) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: OK 19206) |
| Enumeration Date | 2009-12-25 |
| Last Update Date | 2009-12-25 |