| NPI | 1275542623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CT 64557) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 70496) |
| 207X00000X Orthopaedic Surgery (Licence: FL ME109934) | |
| 207X00000X Orthopaedic Surgery (Licence: NJ 25MA09184300) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2019-11-12 |