NPI | 1235526518 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: NE 34536) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2015-04-23 |
Last Update Date | 2025-08-21 |