| NPI | 1639791254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: TX V9723) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX V9723) |
| 207X00000X Orthopaedic Surgery (Licence: AL DO.2730) | |
| 207X00000X Orthopaedic Surgery (Licence: AR E-19088) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-05-18 |
| Last Update Date | 2026-08-14 |