| NPI | 1205253648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: NY 308148) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 283003) |
| 208200000X Plastic Surgery (Licence: NY 308148) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-03-24 |
| Last Update Date | 2023-05-03 |