| NPI | 1891292066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2024-01324) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NM DO2023-1091) |
| 207X00000X Orthopaedic Surgery (Licence: OR PG188549) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-04-12 |
| Last Update Date | 2024-10-21 |