| NPI | 1457328254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: CA A30797) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: AZ 33812) |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2007-07-08 |