NPI | 1043876402 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 208600000X Surgery (Licence: MA 000000000) |
Enumeration Date | 2019-05-11 |
Last Update Date | 2020-03-27 |