| NPI | 1194264374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: UT 13403304-1204) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 5315087631) |
| 207X00000X Orthopaedic Surgery (Licence: MI 510102355) | |
| 207X00000X Orthopaedic Surgery (Licence: AZ 009488) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-02-21 |
| Last Update Date | 2023-07-20 |