NPI | 1972063097 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: MN 67725) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: MN 30013) |
Enumeration Date | 2019-03-24 |
Last Update Date | 2020-08-24 |