| NPI | 1871542126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA G75080) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CA G75080) |
| Enumeration Date | 2006-05-06 |
| Last Update Date | 2008-07-22 |