NPI | 1952575342 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CA A95627) |
Additional Taxonomies | 208600000X Surgery (Licence: CA A95627) |
Enumeration Date | 2008-04-16 |
Last Update Date | 2020-07-06 |