| NPI | 1992032544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: FL ME119706) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CA A111154) |
| Enumeration Date | 2009-11-03 |
| Last Update Date | 2020-11-10 |