| NPI | 1760915300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: PA MT229485) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NY 330221-01) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 63891) | |
| Enumeration Date | 2017-04-11 |
| Last Update Date | 2024-06-21 |