NPI | 1548391980 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: FL MFC1851) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: PA LT000631) |
208200000X Plastic Surgery (Licence: PA MD432684) | |
Enumeration Date | 2007-03-08 |
Last Update Date | 2021-12-09 |