| NPI | 1831396209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2015-02426) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101253682) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: IL 036-129623) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116019410) | |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2016-02-16 |