| NPI | 1255027181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL F346067963110) |
| Enumeration Date | 2023-04-13 |
| Last Update Date | 2023-04-17 |