NPI | 1780883819 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: PA MD447700) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: GA 67244) |
Enumeration Date | 2007-07-18 |
Last Update Date | 2025-03-07 |