| NPI | 1033198742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: OH 35.095799) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35.095799) |
| 2086S0127X Surgery Trauma Surgery (Licence: OH 35.095799) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2021-12-17 |