| NPI | 1265757769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: OH 35.129257) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: VA 0101258243) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: MD D79334) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: KY TP268) | |
| Enumeration Date | 2010-03-29 |
| Last Update Date | 2016-07-14 |