| NPI | 1750709663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: TN 0000062875) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TN 0000062875) | |
| Enumeration Date | 2014-03-29 |
| Last Update Date | 2023-01-30 |