| NPI | 1528413978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 4301500237) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: MI 4301500237) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MI 4301500237) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301115995) | |
| Enumeration Date | 2016-05-03 |
| Last Update Date | 2022-07-19 |