| NPI | 1548465107 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: TX P0785) | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX P0785) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-06-15 | 
| Last Update Date | 2024-10-21 |