| NPI | 1528293271 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CO DR.0055724) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT195496) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT195496) | |
| 207X00000X Orthopaedic Surgery (Licence: NM MD2014-0502) | |
| Enumeration Date | 2009-05-26 |
| Last Update Date | 2016-01-24 |