| NPI | 1679610950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CO 45774) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL-1746) |
| 207X00000X Orthopaedic Surgery (Licence: IN 01071146A) | |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2021-06-17 |