NPI | 1205035102 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: NC 2013-00923) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: TX P6658) |
208600000X Surgery (Licence: SC LL28527) | |
2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NC 2013-00923) | |
2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX P6658) | |
Enumeration Date | 2007-07-12 |
Last Update Date | 2020-10-25 |