| NPI | 1477997815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: UT 12857884-1205) |
| Additional Taxonomies | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: UT 12857884-1205) |
| 208600000X Surgery (Licence: TX R6404) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-04-27 |
| Last Update Date | 2022-08-28 |