| NPI | 1376930776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: NY 305254) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 305254) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-23 |
| Last Update Date | 2021-12-07 |