| NPI | 1659766434 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NH 21876) | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NH 21876) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-03-30 | 
| Last Update Date | 2021-09-11 |