| NPI | 1568084960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AL MD.51035) |
| Additional Taxonomies | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: SC 96799) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 261792) | |
| Enumeration Date | 2020-05-08 |
| Last Update Date | 2026-09-16 |