NPI | 1326286576 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: FL ME138619) |
Additional Taxonomies | 174400000X Specialist |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2009-01-27 |
Last Update Date | 2022-09-20 |