| NPI | 1982703740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: IN 01067142A) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: VA 0101240846) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2012-01-25 |