NPI | 1013118801 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: CA G60000) |
Additional Taxonomies | 208600000X Surgery (Licence: CA G60000) |
Enumeration Date | 2007-05-30 |
Last Update Date | 2019-09-20 |