| NPI | 1881984672 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: AZ 55829) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| Enumeration Date | 2011-04-13 | 
| Last Update Date | 2018-07-26 |