NPI | 1104701960 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: CA A204709) |
Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CA A204709) |
2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: R27765) | |
Enumeration Date | 2025-08-09 |
Last Update Date | 2025-09-22 |