| NPI | 1285078030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME159747) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IL 036151084) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-04-24 |
| Last Update Date | 2023-05-01 |