| NPI | 1922328921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: WI 70467) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301096371) |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: SC TL38580) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301096371) | |
| Enumeration Date | 2010-06-02 |
| Last Update Date | 2019-07-03 |