NPI | 1366659591 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 4301109309) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KY 40760) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 116018135) | |
Enumeration Date | 2007-05-17 |
Last Update Date | 2020-10-22 |