NPI | 1508997032 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: MI 4301030689) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: WY 2735A) |
208200000X Plastic Surgery (Licence: PA MD430264) | |
208200000X Plastic Surgery (Licence: NC 30028) | |
Enumeration Date | 2007-03-08 |
Last Update Date | 2010-03-08 |