| NPI | 1164674651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: TX P2866) |
| Additional Taxonomies | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: TX P2866) |
| 208200000X Plastic Surgery (Licence: NY 248029-1) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NY 248029-1) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX P2866) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 248029-1) | |
| Enumeration Date | 2008-10-16 |
| Last Update Date | 2012-09-04 |