| NPI | 1831580943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SD 12531) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IA DO-05734) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-02-11 |
| Last Update Date | 2021-04-22 |