| NPI | 1437395308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: MI 4301104077) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MI 4301104077) |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: MN 105092) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: MN 53259) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-12-26 |
| Last Update Date | 2016-09-02 |