| NPI | 1609261916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN MD73339) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KS 04-45145) |
| 207X00000X Orthopaedic Surgery (Licence: NC 2022-00114) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2025-02-25 |