| NPI | 1134743511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 324438) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AL 5765F) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-06-02 |
| Last Update Date | 2024-10-28 |