NPI | 1821323163 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: TX Q9962) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: TX 44432) |
Enumeration Date | 2009-10-05 |
Last Update Date | 2016-12-19 |