NPI | 1477800134 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: ID M-15773) |
Additional Taxonomies | 208600000X Surgery (Licence: IL 036145857) |
208600000X Surgery (Licence: PA MT201381) | |
2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: ID M-15773) | |
Enumeration Date | 2012-08-12 |
Last Update Date | 2021-06-23 |