NPI | 1578508735 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2082S0099X Plastic Surgery Plastic Surgery Within the Head and Neck (Licence: MS 17013) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: MS 17013) |
Enumeration Date | 2006-06-19 |
Last Update Date | 2013-08-26 |