| NPI | 1457747305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 35.146911) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A147510) |
| 207X00000X Orthopaedic Surgery (Licence: WA MD61352803) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2023-01-25 |