| NPI | 1619613148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 289055) |
| Enumeration Date | 2022-05-09 |
| Last Update Date | 2023-06-21 |