| NPI | 1124463807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AR E-12086) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX R7113) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-05-07 |
| Last Update Date | 2023-08-25 |