| NPI | 1881076784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: KY 57246) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KY TP988) |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: KY TP988) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207X00000X Orthopaedic Surgery (Licence: KY 57246) | |
| Enumeration Date | 2015-06-26 |
| Last Update Date | 2023-05-02 |