| NPI | 1427491257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NC 2019-00506) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207X00000X Orthopaedic Surgery (Licence: NC 2019-00506) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 191276) | |
| Enumeration Date | 2013-04-11 |
| Last Update Date | 2021-02-24 |