| NPI | 1679069991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0105X Surgery, Surgery of the Hand (Licence: KY FT579) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: KY FT579) |
| Enumeration Date | 2018-07-10 |
| Last Update Date | 2018-07-10 |