NPI | 1811155450 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: FL ME127463) |
Additional Taxonomies | 208D00000X General Practice (Licence: KY 47294) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN12168) | |
Enumeration Date | 2008-05-30 |
Last Update Date | 2020-10-07 |