NPI | 1194259960 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101278009) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 227592) |
Enumeration Date | 2017-04-18 |
Last Update Date | 2023-07-06 |