| NPI | 1457541500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: TX N3417) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: NY 243409) |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2012-10-10 |