| NPI | 1013211879 |
|---|---|
| Former Name | JIMMY JOSEPH |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 253642) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 253642) |
| Enumeration Date | 2011-01-07 |
| Last Update Date | 2013-08-20 |