| NPI | 1548403389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: FL ME135022) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN MD51921) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: OH 35.126962) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-04-09 |
| Last Update Date | 2018-05-16 |