| NPI | 1750504528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX N5907) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: TX n5907) |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: TX n5907) | |
| 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: TX n5907) | |
| 208600000X Surgery (Licence: TX n5907) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: CA A82491) | |
| 2086S0105X Surgery, Surgery of the Hand (Licence: TX n5907) | |
| 2086S0105X Surgery, Surgery of the Hand (Licence: CA A82491) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CA A82491) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: TX n5907) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: CA A82491) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: TX n5907) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: CA A82491) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2018-03-22 |