| NPI | 1760893283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 302063) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA TR 60459940) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-05-19 |
| Last Update Date | 2022-07-08 |