| NPI | 1235472036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN 59043) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KY 51513) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-03-29 |
| Last Update Date | 2021-10-04 |