NPI | 1033776349 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: PA MD489248) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: RI LP04563) |
Enumeration Date | 2019-05-22 |
Last Update Date | 2025-07-23 |