| NPI | 1164088605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: CA 20A19340) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA 20A19340) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-05-09 |
| Last Update Date | 2024-06-24 |