| NPI | 1033409842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2017-00736) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD457426) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207X00000X Orthopaedic Surgery (Licence: NJ 25MA09863900) | |
| Enumeration Date | 2011-04-13 |
| Last Update Date | 2023-09-01 |