| NPI | 1639412976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: MA 278025) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 278025) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-04-05 |
| Last Update Date | 2023-01-17 |