| NPI | 1538728308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 58031898) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA Ot019232) |
| Enumeration Date | 2019-06-06 |
| Last Update Date | 2024-08-02 |