| NPI | 1528347234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: TX R3481) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: NV DO2046) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TN 34) | |
| Enumeration Date | 2011-08-11 |
| Last Update Date | 2021-09-08 |