NPI | 1699794685 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: KY 33754) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: OH 73700) |
Enumeration Date | 2006-07-19 |
Last Update Date | 2015-07-16 |