| NPI | 1891942850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX P5855) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TX P5855) | |
| Enumeration Date | 2008-08-21 |
| Last Update Date | 2024-07-16 |