| NPI | 1790246239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: NJ 25MA12670900) | |
| 208200000X Plastic Surgery (Licence: NJ 25MA12670900) | |
| Enumeration Date | 2019-03-27 |
| Last Update Date | 2026-04-07 |