| NPI | 1487090049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA 20A13918) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: UT 10796316-1204) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OK G083433500) | |
| Enumeration Date | 2013-05-21 |
| Last Update Date | 2020-07-27 |