NPI | 1689802704 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: SC 88707) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: OH 35134127) |
Enumeration Date | 2009-06-26 |
Last Update Date | 2022-11-15 |