| NPI | 1811971807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NH 17031) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: NH LT-3507) |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2015-05-15 |