| NPI | 1346223948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN 3409) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IN 100006796A) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TN 57) | |
| Enumeration Date | 2005-11-28 |
| Last Update Date | 2019-12-17 |