| NPI | 1851618854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 57.018579) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD457405) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-04-29 |
| Last Update Date | 2021-02-02 |