| NPI | 1831549922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MD D99232) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT210916) |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2024-01-03 |