NPI | 1003317934 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PR 23961) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 6177799) |
Enumeration Date | 2018-02-26 |
Last Update Date | 2025-02-27 |