| NPI | 1477059574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX U9960) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: LA 337579) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-04-05 |
| Last Update Date | 2024-10-01 |