NPI | 1871026278 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: MD D0099377) |
Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: DC MD500002596) |
Enumeration Date | 2017-04-04 |
Last Update Date | 2025-09-25 |