NPI | 1033524756 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 319022) |
Additional Taxonomies | 208600000X Surgery (Licence: IL 125.065598) |
Enumeration Date | 2014-06-23 |
Last Update Date | 2023-05-23 |