| NPI | 1194114975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2021007889) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KS 94-08864) |
| 207X00000X Orthopaedic Surgery (Licence: KS 0444403) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-01-15 |
| Last Update Date | 2023-03-06 |