| NPI | 1578901039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC 82309) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101263695) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-06-06 |
| Last Update Date | 2020-10-22 |