| NPI | 1093030819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD447484) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: PA MD447484) | |
| Enumeration Date | 2010-04-05 |
| Last Update Date | 2016-08-22 |