| NPI | 1831108570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: PA MD462278) |
| Additional Taxonomies | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: NY 248215) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NY 248215) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2022-07-21 |