| NPI | 1366455446 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: OH 35.099884) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CA A116423) |
| 208200000X Plastic Surgery (Licence: FL 496688) | |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2016-11-17 |