| NPI | 1649502121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 35.128901) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: MI 4301099499) |
| 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: MI 4301099499) | |
| 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: MI 4301099499) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 57.016682) | |
| Enumeration Date | 2010-02-08 |
| Last Update Date | 2017-12-08 |