| NPI | 1700575479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: RI CLP05847) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: RI CLP05847) |
| Enumeration Date | 2023-05-08 |
| Last Update Date | 2023-06-27 |