| NPI | 1013178912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101256350) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: DC MTL001045) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2023-11-27 |