| NPI | 1447661822 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: SD 13665) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207X00000X Orthopaedic Surgery (Licence: NC 2021-03213) | |
| 208D00000X General Practice (Licence: HI 18549) | |
| Enumeration Date | 2014-05-19 |
| Last Update Date | 2026-04-28 |