| NPI | 1194083071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OR MD186815) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NM RS2017-0430) |
| 207X00000X Orthopaedic Surgery (Licence: CA A128483) | |
| 207X00000X Orthopaedic Surgery (Licence: NM MD2018-0088) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-27 |
| Last Update Date | 2023-01-11 |