| NPI | 1689808826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA09904500) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A135257) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 156747) | |
| Enumeration Date | 2009-05-02 |
| Last Update Date | 2026-08-03 |