NPI | 1841264447 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: NY 208801) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: CT 041954) |
Enumeration Date | 2006-02-13 |
Last Update Date | 2019-06-26 |