| NPI | 1295267243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX U5410) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NV 21844) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NV 21844) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2023-08-30 |