NPI | 1730522061 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: NJ 25MA10287200) |
Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CT 68908) |
Enumeration Date | 2013-04-17 |
Last Update Date | 2022-08-25 |