| NPI | 1053739185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: CA a170626) |
| Additional Taxonomies | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: CA a170626) |
| 208600000X Surgery (Licence: MD D89169) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: CA A170626) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-05 |
| Last Update Date | 2022-10-06 |