NPI | 1851590723 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: FL ME105769) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: MS 19915) |
Enumeration Date | 2007-07-12 |
Last Update Date | 2014-09-18 |