NPI | 1811143316 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: GA 66232) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: IL 036.115100) |
208200000X Plastic Surgery (Licence: NY 257461) | |
Enumeration Date | 2008-08-15 |
Last Update Date | 2022-01-07 |