| NPI | 1619479318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KY 05551) |
| Additional Taxonomies | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: KY 05551) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-08 |
| Last Update Date | 2024-05-17 |