| NPI | 1396771424 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NY 256232) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: FL ME95604) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2024-08-15 |