| NPI | 1588863880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: UT 6941883-1205) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: UT 6941883-1205) | |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2026-04-16 |