| NPI | 1699090431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: TX Q4744) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CA A138672) |
| Enumeration Date | 2010-04-05 |
| Last Update Date | 2017-05-01 |