NPI | 1396242285 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 334008) |
Additional Taxonomies | 208D00000X General Practice (Licence: AL MD.39291) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-04-09 |
Last Update Date | 2025-05-04 |