| NPI | 1508108010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 35.143360) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101257211) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-03-22 |
| Last Update Date | 2022-03-10 |