| NPI | 1962857219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: IN 01082753A) |
| Additional Taxonomies | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: FL ME139465) |
| 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: KY 55142) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-04-24 |
| Last Update Date | 2024-08-02 |