NPI | 1871837377 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: TX R4439) |
Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: TX 45387) |
2086S0102X Surgery, Surgical Critical Care (Licence: TX BP10045281) | |
Enumeration Date | 2012-11-21 |
Last Update Date | 2021-05-12 |