| NPI | 1497074876 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: GA 76102)  | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 34.011328)  | 
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: AL DO.1629)  | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-05-24 | 
| Last Update Date | 2020-11-19 |