| NPI | 1831452580 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 35.133935) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IL 125061743) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2022-01-25 |