| NPI | 1285871913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: CA 20A14054) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2009-01-16 |
| Last Update Date | 2023-05-15 |