| NPI | 1821447020 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: MI 4301117263) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301109711) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116035012) | |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2024-03-29 |