NPI | 1952583932 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: MD H72202) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: MA 242456) |
Enumeration Date | 2007-11-30 |
Last Update Date | 2019-10-11 |