NPI | 1720063480 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: TX J0116) |
Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX J0116) |
Enumeration Date | 2005-12-14 |
Last Update Date | 2019-02-06 |