| NPI | 1144677584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: TX S8379) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX S8379) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2025-10-16 |