NPI | 1245285048 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: CA A92907) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: NY 271451) |
208200000X Plastic Surgery (Licence: AL 22756) | |
Enumeration Date | 2006-05-23 |
Last Update Date | 2019-11-13 |