NPI | 1689851172 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: NY 256024) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: NJ 25MA08738100) |
Enumeration Date | 2008-01-28 |
Last Update Date | 2023-05-23 |