| NPI | 1366685166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: MT MED-PHYS-LIC-116543) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101257708) |
| 207X00000X Orthopaedic Surgery (Licence: OR MD161746) | |
| 207X00000X Orthopaedic Surgery (Licence: NC 2016-00601) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NC 2016-00601) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: VA 0101257708) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-04-09 |
| Last Update Date | 2023-09-04 |