| NPI | 1881186807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: LA 344021) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301115857) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116038655) | |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2025-01-27 |