NPI | 1124003421 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: MD D0023431) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: NH 22431) |
208200000X Plastic Surgery (Licence: DC MD10918) | |
208200000X Plastic Surgery (Licence: WI 2909) | |
Enumeration Date | 2005-12-08 |
Last Update Date | 2023-04-12 |