NPI | 1265598130 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CT 049538) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: PA MT185935) |
208200000X Plastic Surgery (Licence: CT MD 049538) | |
Enumeration Date | 2006-12-28 |
Last Update Date | 2019-10-11 |