| NPI | 1235491432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101255451) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WV 3357) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-06-13 |
| Last Update Date | 2024-07-02 |