| NPI | 1275053845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA OS019606) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 315876-01) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA OS019606) | |
| Enumeration Date | 2017-06-23 |
| Last Update Date | 2024-06-26 |