| NPI | 1447784913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX U2504) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A174910) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-12 |
| Last Update Date | 2023-12-06 |