| NPI | 1003461377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 317968) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NY 317968) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN29859) | |
| Enumeration Date | 2019-08-05 |
| Last Update Date | 2023-07-22 |