NPI | 1083779623 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: MI 4301047649) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: MI 4301047649) |
Enumeration Date | 2006-12-26 |
Last Update Date | 2009-02-28 |