| NPI | 1598185092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN 60838) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 277969) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-23 |
| Last Update Date | 2026-01-14 |