| NPI | 1942564778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TX R6780) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX R6780) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IA R-10796) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11016735) | |
| Enumeration Date | 2012-06-26 |
| Last Update Date | 2018-12-20 |