| NPI | 1336675016 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: UT 13363810-1205) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0116030291) |
| 207X00000X Orthopaedic Surgery (Licence: AL 44582) | |
| 207X00000X Orthopaedic Surgery (Licence: FL ME157211) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2023-04-28 |