NPI | 1588059430 |
---|---|
Former Name | KAITLYN MARIE ALCORN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: NY 312382) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: NJ 25MA11233000) |
208200000X Plastic Surgery (Licence: CT 69381) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2015-03-30 |
Last Update Date | 2022-04-21 |