| NPI | 1710270541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD61056148) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301098486) |
| 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: WA MD61056148) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: KY 48938) | |
| Enumeration Date | 2011-05-26 |
| Last Update Date | 2020-09-10 |