| NPI | 1487997862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA 60957182) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 63022) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: AZ 56065) | |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2019-07-10 |