| NPI | 1174048292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PR 35542) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208600000X Surgery (Licence: PR 15278) | |
| Enumeration Date | 2017-08-09 |
| Last Update Date | 2021-12-15 |