| NPI | 1437576386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX T1052) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 83328) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: TX T1052) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-03-27 |
| Last Update Date | 2022-02-09 |