| NPI | 1407044399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NV 13247) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: UT 6664375-1205) |
| Enumeration Date | 2007-10-04 |
| Last Update Date | 2012-08-09 |