| NPI | 1518063189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: TN 37558) |
| Additional Taxonomies | 208600000X Surgery (Licence: TN MD37558) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2019-11-11 |