| NPI | 1508307737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NY 304050) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: IA R-10963) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NY 304050) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NY P101696) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2023-08-03 |