| NPI | 1346745767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116037517) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 65995) |
| 207X00000X Orthopaedic Surgery (Licence: MN 29304) | |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2024-01-11 |