NPI | 1366654691 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NE 26445) |
Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer |
390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN11769) | |
Enumeration Date | 2007-05-07 |
Last Update Date | 2012-06-23 |