NPI | 1144754169 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: OH 35.148630) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2022-01050) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-04-17 |
Last Update Date | 2023-08-21 |