NPI | 1700824828 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: CA C55493) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 024942) |
2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: LA 024942) | |
208200000X Plastic Surgery (Licence: LA 024942) | |
Enumeration Date | 2006-06-02 |
Last Update Date | 2013-08-15 |