| NPI | 1780811786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: TX T9161) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CA A114551) |
| Enumeration Date | 2009-06-17 |
| Last Update Date | 2022-11-01 |