| NPI | 1831839760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AL L.6193) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208600000X Surgery (Licence: SC LL87746) | |
| Enumeration Date | 2022-03-30 |
| Last Update Date | 2024-10-08 |