| NPI | 1033437330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME123118) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN 54727) |
| 207X00000X Orthopaedic Surgery (Licence: VA 0101270907) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-05-11 |
| Last Update Date | 2025-10-09 |