| NPI | 1417443730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: KY FT585) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: KY FT585) |
| Enumeration Date | 2018-07-10 |
| Last Update Date | 2018-07-10 |