| NPI | 1154522746 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0105X Surgery, Surgery of the Hand (Licence: ND 12465) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN9862) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2012-12-10 |