| NPI | 1699153601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ME MD24435) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A169417) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2021-09-16 |