NPI | 1053451518 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: CA A-121399) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: CA A121399) |
208600000X Surgery (Licence: OK 24625) | |
Enumeration Date | 2007-02-07 |
Last Update Date | 2019-12-20 |