| NPI | 1578592895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AR E-12426) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IL 125.062786) |
| 207X00000X Orthopaedic Surgery (Licence: CA A156007) | |
| 225100000X Physical Therapist (Licence: OK 3952) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2024-06-10 |