| NPI | 1316326234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 75959) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2020016496) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2021-10-29 |