NPI | 1639461460 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME132652) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
207X00000X Orthopaedic Surgery (Licence: NC 2016-00650) | |
Enumeration Date | 2011-05-12 |
Last Update Date | 2024-11-12 |