| NPI | 1053738476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2021-03321) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A143332) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-03-24 |
| Last Update Date | 2022-03-30 |