| NPI | 1124448972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: TX T3275) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: PA MD468280) |
| 2086S0127X Surgery, Trauma Surgery (Licence: PA MD468280) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-20 |
| Last Update Date | 2021-10-06 |