| NPI | 1356389241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CA G048588) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA G048588) |
| 208200000X Plastic Surgery (Licence: CA G048588) | |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2010-08-30 |