| NPI | 1801215363 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: NC 2022-01416) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME141988) |
| 207X00000X Orthopaedic Surgery (Licence: NC 2022-01416) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: DC 39020000X) | |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2023-09-21 |