| NPI | 1316163405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery Hand Surgery (Licence: NC 2010-00468) |
| Additional Taxonomies | 207XS0106X Orthopaedic Surgery Hand Surgery (Licence: TN MD44236) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301083852) | |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2013-11-07 |