NPI | 1578728853 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: MA 240847) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: CA A89839) |
Enumeration Date | 2008-07-25 |
Last Update Date | 2019-11-08 |