| NPI | 1699909119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: NE 28477) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: VA 0116021453) | |
| 207X00000X Orthopaedic Surgery (Licence: NE 28477) | |
| Enumeration Date | 2009-05-12 |
| Last Update Date | 2016-03-01 |