| NPI | 1881216901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A200997) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MO xxxx) |
| Enumeration Date | 2020-05-12 |
| Last Update Date | 2025-08-08 |