| NPI | 1144612318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KY 04683) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 34.014347) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-02-25 |
| Last Update Date | 2020-06-08 |