NPI | 1316948532 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: NC 2012-00143) |
Additional Taxonomies | 208600000X Surgery (Licence: NY 00243105) |
Enumeration Date | 2005-08-10 |
Last Update Date | 2014-05-16 |