| NPI | 1992709323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: WI 28087) |
| Additional Taxonomies | 174400000X Specialist (Licence: WI 28087) |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2008-05-19 |