| NPI | 1891088332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VT 042-0015248) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CO 56208) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: VT 042-0015248) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301098466) | |
| 207X00000X Orthopaedic Surgery (Licence: MI 4301098466) | |
| Enumeration Date | 2011-05-17 |
| Last Update Date | 2021-07-23 |