| NPI | 1003234048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: CT 1.071668) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: NY 288418) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: NJ 25MA11052800) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-05 |
| Last Update Date | 2022-10-31 |