NPI | 1417110974 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: FL 149705) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: IL 036124471) |
208200000X Plastic Surgery (Licence: MD D0083687) | |
Enumeration Date | 2008-07-04 |
Last Update Date | 2021-03-25 |