NPI | 1518264449 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 279158) |
Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NY 279158) |
207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NY 279158) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2011-02-11 |
Last Update Date | 2017-09-01 |