NPI | 1336209345 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: OR md26066) |
Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CA GO78756) |
Enumeration Date | 2006-12-11 |
Last Update Date | 2024-03-19 |