NPI | 1861424558 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX K2021) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: TX K2021) |
Enumeration Date | 2006-07-06 |
Last Update Date | 2016-08-03 |