NPI | 1104246339 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: CA A142610) |
Additional Taxonomies | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: CA A142610) |
390200000X Student in an Organized Health Care Education/Training Program | |
2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: CA A142610) | |
Enumeration Date | 2014-04-28 |
Last Update Date | 2021-07-27 |