| NPI | 1548651540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: UT 12773264-1205) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ R75475) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: VA 0116035009) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-02-11 |
| Last Update Date | 2022-11-04 |