| NPI | 1700205903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO DR.0063306) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CO DR.0063306) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2019-11-19 |