| NPI | 1033578190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: OH 34.015261) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL OS15141) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-02-17 |
| Last Update Date | 2021-07-28 |