| NPI | 1225533862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2024033138) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A184171) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2025-03-17 |