| NPI | 1427445634 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: VA 0101272648) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| Enumeration Date | 2015-04-26 | 
| Last Update Date | 2021-11-12 |