NPI | 1891019428 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: OR MD182026) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: WA MD60292214) |
Enumeration Date | 2010-03-25 |
Last Update Date | 2018-03-02 |