NPI | 1053766360 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 35.145520) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME150357) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2016-04-25 |
Last Update Date | 2023-11-03 |