NPI | 1942380787 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: CA G076688) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: FL 131200) |
Enumeration Date | 2006-10-16 |
Last Update Date | 2022-07-21 |