| NPI | 1356787188 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX S5377) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35.136220) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-05-20 |
| Last Update Date | 2020-09-08 |