| NPI | 1891775037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: FL HSE19077) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: FL TRN22476) |
| Enumeration Date | 2006-01-21 |
| Last Update Date | 2016-02-01 |