| NPI | 1871931386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: FL ME138062) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208200000X Plastic Surgery (Licence: NM Md2019-0493) | |
| Enumeration Date | 2013-06-06 |
| Last Update Date | 2023-06-26 |