| NPI | 1184163594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA OS023113) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2086S0102X Surgery, Surgical Critical Care (Licence: PA OS023113) | |
| Enumeration Date | 2017-02-17 |
| Last Update Date | 2023-10-23 |