NPI | 1558821108 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: UT 14231097-1205) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: IL 125.074941) |
208200000X Plastic Surgery (Licence: UT 14231097-1205) | |
Enumeration Date | 2019-03-20 |
Last Update Date | 2025-07-25 |