| NPI | 1861605115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NE 24538) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NE tep4471) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2018-10-05 |