NPI | 1962851667 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: UT 11236456-1204) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NM R-07-2016MNT) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2016-06-03 |
Last Update Date | 2020-08-10 |