| NPI | 1811398035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 88016) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN 65162) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-09-07 |
| Last Update Date | 2022-08-24 |