NPI | 1164781514 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: IN 01086118A) |
Additional Taxonomies | 208600000X Surgery (Licence: WA MD60845488) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2012-05-04 |
Last Update Date | 2021-09-17 |