| NPI | 1144463373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX P3332) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TX p3332) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-04-17 |
| Last Update Date | 2021-12-29 |