| NPI | 1689607020 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: CA A52624) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A52624) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2007-07-08 |