NPI | 1831289099 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: FL ME72794) |
Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MD 10794) |
Enumeration Date | 2006-10-16 |
Last Update Date | 2009-04-14 |