| NPI | 1447419577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TN 51379) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301092302) |
| 207X00000X Orthopaedic Surgery (Licence: TN 51379) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301092302) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: OH 35121293) | |
| Enumeration Date | 2008-06-04 |
| Last Update Date | 2020-06-08 |