| NPI | 1689962516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA 20A15693) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 269470) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-07-12 |
| Last Update Date | 2021-04-15 |