| NPI | 1437106283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: WA MD60572161) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CA A055919) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2015-08-31 |