NPI | 1629568845 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX V1573) |
Enumeration Date | 2018-05-14 |
Last Update Date | 2024-06-18 |