| NPI | 1053621078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 074072) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA OT013214) |
| 207X00000X Orthopaedic Surgery (Licence: PA OS015919) | |
| 207X00000X Orthopaedic Surgery (Licence: AR E-8622) | |
| Enumeration Date | 2010-10-08 |
| Last Update Date | 2016-10-12 |