| NPI | 1851596092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: OH 35134985) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX P5933) |
| 207X00000X Orthopaedic Surgery (Licence: FL ME111596) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2019-01-31 |