| NPI | 1407080245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: IN 01075645A) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KY R2217) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: OH 35.129960) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-05-07 |
| Last Update Date | 2023-11-08 |