| NPI | 1871769117 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD444475) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA11229300) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-05-06 |
| Last Update Date | 2021-11-01 |