| NPI | 1366896797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OR MD214297) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ R75494) |
| 207X00000X Orthopaedic Surgery (Licence: AZ R75494) | |
| 207X00000X Orthopaedic Surgery (Licence: CT 70189) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-04-21 |
| Last Update Date | 2023-08-10 |