| NPI | 1265095947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: OK 45827) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207X00000X Orthopaedic Surgery (Licence: TX S7343) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: TN 68497) | |
| Enumeration Date | 2019-04-17 |
| Last Update Date | 2025-09-22 |