| NPI | 1699333567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 4351045574) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: CA A201224) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2025-09-02 |