| NPI | 1760989677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX U9237) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2086S0105X Surgery, Surgery of the Hand (Licence: TX U9237) | |
| Enumeration Date | 2018-04-07 |
| Last Update Date | 2024-07-24 |