| NPI | 1134416977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: MI 4301503008) |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2024-07-30 |