| NPI | 1851657845 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: CA A149767) | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A149767) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-04 | 
| Last Update Date | 2019-08-21 |