| NPI | 1407882004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: CA A75906) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CA A75906) |
| 208600000X Surgery (Licence: CA A75906) | |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2018-05-04 |