| NPI | 1366970709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: NJ 25MB11576300) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NJ 207X00000X) |
| 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: MI 5151015347) | |
| Enumeration Date | 2017-05-30 |
| Last Update Date | 2023-08-16 |