| NPI | 1023246923 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: GA 73622) | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX BP10034236) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207X00000X Orthopaedic Surgery (Licence: GA 73622) | |
| Enumeration Date | 2009-06-30 | 
| Last Update Date | 2015-07-23 |