| NPI | 1205323102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2082S0105X Plastic Surgery Surgery of the Hand (Licence: PA MT230668) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MI 4301115518) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2024-06-29 |