| NPI | 1548423262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: MD D0082656) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: MI 4301091949) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 268342) | |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2018-03-17 |