| NPI | 1902223043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: CO DR.0064327) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: UT 11268151-1205) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2022-03-16 |