NPI | 1275929309 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: NJ 25MA11727000) |
Additional Taxonomies | 208600000X Surgery (Licence: NJ 25MA11727000) |
Enumeration Date | 2015-04-15 |
Last Update Date | 2024-06-24 |