| NPI | 1023212024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: SC TL38070) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35.093337) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301090406) | |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2022-07-20 |