| NPI | 1528417698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: TX T5480) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT211056) |
| 207X00000X Orthopaedic Surgery (Licence: PA MD468460) | |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2022-07-26 |