| NPI | 1043604176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME156113) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: FL ME156113) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-03-26 |
| Last Update Date | 2024-08-13 |