| NPI | 1003178427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: OH 35.134079) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 57.030517) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN17652) | |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2020-12-29 |