| NPI | 1154732295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2020-02572) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MS 26429) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-05-12 |
| Last Update Date | 2021-08-07 |