| NPI | 1154784163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: TX U5220) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208200000X Plastic Surgery (Licence: WA MD.MD.61271435) | |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2024-01-23 |