NPI | 1013053438 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: CA G076663) |
Additional Taxonomies | 208600000X Surgery (Licence: CA G076663) |
2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CA G076663) | |
Enumeration Date | 2007-01-30 |
Last Update Date | 2007-07-08 |