| NPI | 1073947719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: OR MD183450) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OR MD183450) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-08-29 |
| Last Update Date | 2024-08-27 |