NPI | 1497497242 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: MI 5101028978) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
207X00000X Orthopaedic Surgery (Licence: MI 5101028978) | |
Enumeration Date | 2022-04-12 |
Last Update Date | 2025-10-15 |