| NPI | 1568773372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: KS 04-39175) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CA 143732) |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2017-11-28 |