| NPI | 1477719409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: PA MD461479) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CA A137620) |
| Enumeration Date | 2008-07-29 |
| Last Update Date | 2022-07-21 |