| NPI | 1659339422 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: CA G38023) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA G38023) |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2008-06-06 |