| NPI | 1851554216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: AZ 006133) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 006133) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA OT012676) | |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2017-04-27 |