| NPI | 1831875178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: KS 94-11260) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: KS 94-11260) |
| Enumeration Date | 2023-06-22 |
| Last Update Date | 2024-08-19 |