| NPI | 1962857219 |
|---|---|
| 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: FL ME139465) |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: KY 55142) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: IN 01082753a) | |
| Enumeration Date | 2016-04-24 |
| Last Update Date | 2021-03-30 |