NPI | 1760775035 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: TX R1941) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: TX BP10037405) |
Enumeration Date | 2011-05-19 |
Last Update Date | 2021-12-06 |