NPI | 1982869533 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: PA MD443530) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: PA MT193995) |
Enumeration Date | 2008-07-23 |
Last Update Date | 2011-09-08 |