| NPI | 1528252285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: HI MD-18718) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A98652) |
| Enumeration Date | 2007-09-05 |
| Last Update Date | 2021-05-26 |