| NPI | 1689930141 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 272010) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207XS0106X Orthopaedic Surgery Hand Surgery (Licence: NY 272010) | |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2016-06-02 |