NPI | 1134654924 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: WI 70560-20) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2017-04-28 |
Last Update Date | 2019-03-06 |