| NPI | 1013158021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: MA 266203) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MA 266203) | |
| Enumeration Date | 2009-03-20 |
| Last Update Date | 2017-01-11 |