| NPI | 1467015545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NM DO2024-0056) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207X00000X Orthopaedic Surgery (Licence: OR 193972) | |
| Enumeration Date | 2019-04-15 |
| Last Update Date | 2024-11-06 |