| NPI | 1003430406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD478936) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA HS000288L) |
| Enumeration Date | 2020-06-01 |
| Last Update Date | 2025-02-17 |