NPI | 1386821700 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: NJ 25MA09904900) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: PA MD436356) |
Enumeration Date | 2008-01-28 |
Last Update Date | 2020-11-17 |