| NPI | 1720222508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: MT MED-PHYS-LIC-36762) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: OR MD158161) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: CA A130888) | |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: NV 15371) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-04-24 |
| Last Update Date | 2022-07-21 |