| NPI | 1992182679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NE 33561) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 85435) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-05-01 |
| Last Update Date | 2021-08-30 |