NPI | 1811223514 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: CA A175444) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: NY 292030) |
Enumeration Date | 2009-10-30 |
Last Update Date | 2024-05-31 |