NPI | 1306839733 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: NJ MA40682) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: NY 144771) |
Enumeration Date | 2005-08-31 |
Last Update Date | 2007-07-08 |