| NPI | 1114360054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CO DR.0070274) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208600000X Surgery (Licence: AZ 49703) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: CO DR.0070274) | |
| Enumeration Date | 2013-04-10 |
| Last Update Date | 2023-02-23 |