| NPI | 1184886269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL OS14123) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: FL OS14123) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: CO FP4580367) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA OT-012566) | |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2021-03-25 |