| NPI | 1346509759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: MT 67116) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: IA R-10798) | |
| Enumeration Date | 2012-05-07 |
| Last Update Date | 2026-08-27 |