| NPI | 1093204901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KY 59010) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35.149895) |
| 207X00000X Orthopaedic Surgery (Licence: CT 73277) | |
| 207XS0106X Orthopaedic Surgery Hand Surgery (Licence: CT 73277) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-05-07 |
| Last Update Date | 2024-09-20 |