NPI | 1710926548 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: FL ME100894) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: GA 056206) |
Enumeration Date | 2006-06-06 |
Last Update Date | 2019-12-04 |