| NPI | 1538588769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL OS16472) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AL 1533) |
| 207X00000X Orthopaedic Surgery (Licence: SC 83009) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207X00000X Orthopaedic Surgery (Licence: GA 77126) | |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2019-11-19 |