| NPI | 1922319755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: CA A182705) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: GA 078414) |
| Enumeration Date | 2010-06-26 |
| Last Update Date | 2024-02-28 |