| NPI | 1639581085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: HI MD-18348) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207X00000X Orthopaedic Surgery (Licence: WV 33414) | |
| 207X00000X Orthopaedic Surgery (Licence: PA MD489665) | |
| 208D00000X General Practice (Licence: HI MD-18348) | |
| Enumeration Date | 2014-05-20 |
| Last Update Date | 2025-08-22 |