| NPI | 1346509759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery Hand Surgery (Licence: MT 67116) |
| Additional Taxonomies | 207XS0106X Orthopaedic Surgery Hand Surgery (Licence: IA R-10798) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-05-07 |
| Last Update Date | 2022-07-21 |