| NPI | 1013336155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MN 69728) |
| Additional Taxonomies | 2086S0105X Surgery, Surgery of the Hand (Licence: PA MT220437) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2023-07-27 |