NPI | 1851845846 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: PA MD060388L) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: NJ 65266) |
Enumeration Date | 2016-08-08 |
Last Update Date | 2016-08-08 |