| NPI | 1922340967 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: WI 69905-21) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 69905) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: OH 34.012228) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-03-16 |
| Last Update Date | 2021-06-17 |