| NPI | 1144481029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2015-02508) |
| Additional Taxonomies | 2086X0206X Surgery Surgical Oncology (Licence: VA 0101250133) |
| 208600000X Surgery (Licence: VA 0101269649) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2023-12-06 |