| NPI | 1174029771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME169163) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101278447) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2024-09-22 |