| NPI | 1316350382 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: LA 340863) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NE 28909) |
| 207X00000X Orthopaedic Surgery (Licence: MS 27052) | |
| 208D00000X General Practice (Licence: NE 28909) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-06-08 |
| Last Update Date | 2024-08-01 |