NPI | 1669975629 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KY 05666) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KY TP713) |
207X00000X Orthopaedic Surgery (Licence: PA 390200000X) | |
390200000X Student in an Organized Health Care Education/Training Program (Licence: PA OT018504) | |
Enumeration Date | 2018-03-15 |
Last Update Date | 2024-09-20 |