| NPI | 1740396845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: CA C173219) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: NY 205376) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2024-11-20 |