NPI | 1679730907 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: NC 2009-00275) |
Additional Taxonomies | 208600000X Surgery (Licence: IN 11011245A) |
Enumeration Date | 2008-05-22 |
Last Update Date | 2016-06-01 |