| NPI | 1760610810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NV 15732) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 53238) |
| 207X00000X Orthopaedic Surgery (Licence: NV 15732) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2021-02-12 |