| NPI | 1225338932 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: TX Q5047) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX Q5047) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-10-27 |
| Last Update Date | 2020-07-17 |