| NPI | 1003202086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NE 36012) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD D91719) |
| 207X00000X Orthopaedic Surgery (Licence: GA 85339) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2024-04-04 |