| NPI | 1306289681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: CA A131791) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208200000X Plastic Surgery (Licence: CA A131791) | |
| Enumeration Date | 2013-04-16 |
| Last Update Date | 2024-04-29 |