| NPI | 1225599541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 5101029033) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207X00000X Orthopaedic Surgery (Licence: CA 20A22818) | |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2026-02-23 |