| NPI | 1992023972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: AL MD.31413) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AL MD.31413) |
| 207X00000X Orthopaedic Surgery (Licence: NC 2015-00983) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-05-14 |
| Last Update Date | 2021-05-24 |