NPI | 1386052967 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CA a135579) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: CA A135579) |
Enumeration Date | 2014-07-28 |
Last Update Date | 2022-07-22 |