| NPI | 1992332977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AL MD.43555) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: TN 73676) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2025-06-24 |