NPI | 1992730733 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: MD D0066908) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: NJ 25MA07953600) |
Enumeration Date | 2006-07-11 |
Last Update Date | 2013-02-28 |