| NPI | 1053433375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2082S0105X Plastic Surgery Surgery of the Hand (Licence: TX P3315) |
| Additional Taxonomies | 207XS0106X Orthopaedic Surgery Hand Surgery (Licence: MN 105445) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301081432) | |
| 207X00000X Orthopaedic Surgery (Licence: MN 105445) | |
| 207XS0106X Orthopaedic Surgery Hand Surgery (Licence: MN 54404) | |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2012-08-07 |