| NPI | 1043479785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: OH 35.134713) |
| Additional Taxonomies | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: PA MD460956) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 62623) | |
| Enumeration Date | 2008-06-06 |
| Last Update Date | 2019-07-03 |