| NPI | 1659752483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD61172228) |
| Additional Taxonomies | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: WA MD61172228) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11018449A) | |
| Enumeration Date | 2015-06-17 |
| Last Update Date | 2021-08-17 |