| NPI | 1619256328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN 3143) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TN 33) |
| Enumeration Date | 2011-08-11 |
| Last Update Date | 2024-02-26 |