NPI | 1710103890 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: FL ME98794) |
Additional Taxonomies | 208600000X Surgery (Licence: NY 228606) |
Enumeration Date | 2007-04-18 |
Last Update Date | 2023-07-03 |