NPI | 1770787582 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: GA 58734) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: GA 058734) |
Enumeration Date | 2007-06-14 |
Last Update Date | 2015-07-17 |