NPI | 1326432998 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: TX T6924) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI K632615352549) |
Enumeration Date | 2015-03-22 |
Last Update Date | 2025-05-15 |