NPI | 1265413959 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX M0927) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: TX M0927) |
Enumeration Date | 2005-11-09 |
Last Update Date | 2015-09-03 |