NPI | 1710478573 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: OH 35.150824) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
208200000X Plastic Surgery (Licence: WI 73015-20) | |
Enumeration Date | 2018-05-28 |
Last Update Date | 2024-05-29 |