| NPI | 1427373661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: MD D81011) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME123553) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-03-31 |
| Last Update Date | 2022-04-04 |