NPI | 1184621757 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: GA 82763) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: PA OS010619L) |
2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: GA 82763) | |
Enumeration Date | 2005-06-28 |
Last Update Date | 2024-05-21 |