| NPI | 1982047031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD485181) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KS 04-41856) |
| 208D00000X General Practice (Licence: NE 28052) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2024-05-20 |