| NPI | 1427037951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NH 10052) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MA 154434) |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2012-09-04 |