| NPI | 1013207208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 078464) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 2749-320) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-04-09 |
| Last Update Date | 2023-04-03 |