| NPI | 1871819722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101266820) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OR MD166463) |
| 207X00000X Orthopaedic Surgery (Licence: NJ 25MA09869200) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-04-18 |
| Last Update Date | 2022-08-09 |