| NPI | 1417955691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NH 7647) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: ME 012347) |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2007-07-08 |