| NPI | 1821275231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: AZ 49481) |
| Additional Taxonomies | 174400000X Specialist (Licence: AZ 49481) |
| 207X00000X Orthopaedic Surgery (Licence: AZ 49481) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-01-28 |
| Last Update Date | 2019-09-19 |