NPI | 1235293275 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: OH 35.083418) |
Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: WV 23441) |
Enumeration Date | 2006-12-21 |
Last Update Date | 2015-02-09 |