| NPI | 1629384789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: WA OP61064276) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 5101020123) |
| 207X00000X Orthopaedic Surgery (Licence: AZ 009300) | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: AZ 9300) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11015782A) | |
| Enumeration Date | 2010-08-27 |
| Last Update Date | 2022-10-13 |