| NPI | 1114311305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: NY 302719) |
| Enumeration Date | 2015-03-25 |
| Last Update Date | 2023-07-17 |