NPI | 1083902332 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NY 264938) |
Additional Taxonomies | 208600000X Surgery (Licence: NY 264938) |
208200000X Plastic Surgery (Licence: NY 264938) | |
Enumeration Date | 2011-07-20 |
Last Update Date | 2024-10-29 |