| NPI | 1457647505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101262074) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2012014195) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2022-08-12 |