| NPI | 1437307592 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX P8581) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10031393) | 
| Enumeration Date | 2008-09-03 | 
| Last Update Date | 2015-03-12 |