| NPI | 1306379193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: IN 01087737A) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 227783) |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2022-06-07 |