| NPI | 1689945073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: CA A121553) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: ZZ r12717) |
| Enumeration Date | 2012-01-18 |
| Last Update Date | 2012-11-13 |