| NPI | 1548720493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2024-00808) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MS T-3837) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2024-07-19 |