| NPI | 1497041164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA 20A15447) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX Q7880) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2021-08-05 |