| NPI | 1811383268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX T2849) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX BP10052355) |
| 207X00000X Orthopaedic Surgery (Licence: MA 282733) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2021-11-21 |