NPI | 1992182612 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA10920900) |
Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NJ 25MA10920900) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2015-05-01 |
Last Update Date | 2021-07-21 |