| NPI | 1093143497 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: GA 83842) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL 137270) |
| 207X00000X Orthopaedic Surgery (Licence: PR 32138) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 32138) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-10-22 |
| Last Update Date | 2019-08-07 |