| NPI | 1821357179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: NM MD2019-0224) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NM MD2019-0224) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM RS2018-0355) | |
| Enumeration Date | 2012-05-08 |
| Last Update Date | 2020-01-23 |