| NPI | 1629497078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: LA 332444) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME138912) |
| 207X00000X Orthopaedic Surgery (Licence: AR E13114) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2022-11-14 |