| NPI | 1710411848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NY 321151) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A176781) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA A176781) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-15 |
| Last Update Date | 2023-10-27 |