| NPI | 1770343154 |
|---|---|
| Former Name | TYLER HILLIARD THOMAS BRYDGES |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: WA MDRE.ML.61544990) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2024-03-21 |
| Last Update Date | 2024-06-26 |