| NPI | 1588779870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: PA MD438972) |
| Additional Taxonomies | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: PA MD438972) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2011-06-01 |