| NPI | 1114312519 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 315413) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A170275) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: CA A170275) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: CA A170275) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2022-10-06 |