NPI | 1114381118 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: FL ME137411) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME137411) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2016-04-06 |
Last Update Date | 2021-12-20 |