| NPI | 1700380938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A166407) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 1023469) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2026-04-06 |