| NPI | 1699303339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 102777) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AL 50815) |
| 207X00000X Orthopaedic Surgery (Licence: NY 311391) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2025-04-09 |