| NPI | 1225802697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: DC MTL600211610) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: DC MTL600211610) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: DC MTL600211610) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2023-11-07 |
| Last Update Date | 2025-08-13 |