| NPI | 1346700333 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: WI 74081-20) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207X00000X Orthopaedic Surgery (Licence: NM MD2024-0321) | |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2025-09-23 |