NPI | 1003876384 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: MA 36527) |
Additional Taxonomies | 208600000X Surgery (Licence: MA 36527) |
Enumeration Date | 2006-03-23 |
Last Update Date | 2010-12-03 |