| NPI | 1487811808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: DC MD040123) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: TX P3551) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2019-10-25 |