| NPI | 1467496646 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MO 2009 023 891) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CA A99381) |
| 208200000X Plastic Surgery (Licence: FL ME95230) | |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2010-10-08 |