NPI | 1639811185 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: MI 5101028986) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 5101028986) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2022-04-13 |
Last Update Date | 2025-10-15 |