| NPI | 1477931137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD490299) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AR E-14370) |
| 208000000X Pediatrics (Licence: CA A167911) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-05-14 |
| Last Update Date | 2026-04-22 |