| NPI | 1508363912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 72654) |
| Enumeration Date | 2018-04-11 |
| Last Update Date | 2025-01-02 |