NPI | 1013304963 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: NC 2024-01973) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
208600000X Surgery (Licence: TN 56273) | |
Enumeration Date | 2015-04-17 |
Last Update Date | 2024-07-16 |