| NPI | 1801085410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NM 76-199) |
| Additional Taxonomies | 174V00000X Clinical Ethicist |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2007-10-19 |
| Last Update Date | 2012-12-16 |