| NPI | 1801031307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD60140499) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: NC 2009-00480) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: WA MD60140499) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OR LL17811) | |
| Enumeration Date | 2008-12-11 |
| Last Update Date | 2024-12-11 |