| NPI | 1841492931 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: TN 44838) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: TN 44838) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2013-11-05 |