| NPI | 1134324551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: OR MD126124) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OR LL16173) |
| Enumeration Date | 2007-06-16 |
| Last Update Date | 2018-01-03 |