| NPI | 1780942128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CO DR.0062281) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OR MD175625) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-23 |
| Last Update Date | 2021-06-23 |