| NPI | 1346536703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: CA A122776) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 63815) |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: PA MT212625) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2019-05-07 |