| NPI | 1538505979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN 59032) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: TN 59032) | |
| Enumeration Date | 2013-05-13 |
| Last Update Date | 2025-01-29 |