| NPI | 1295178614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: OH 35137015) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35.137015) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301114341) | |
| Enumeration Date | 2013-04-16 |
| Last Update Date | 2019-08-08 |