| NPI | 1225396799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: KY 52757) |
| Additional Taxonomies | 208600000X Surgery (Licence: KY R3116) |
| 208600000X Surgery (Licence: CA A148837) | |
| 208600000X Surgery (Licence: KY IP1384) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: KY 52757) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-05-02 |
| Last Update Date | 2019-07-30 |