| NPI | 1558718387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD484048) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: PA MD484048) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11021795A) | |
| Enumeration Date | 2016-05-23 |
| Last Update Date | 2024-09-03 |