NPI | 1225533060 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: NY 324427) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: 64067) |
Enumeration Date | 2018-03-26 |
Last Update Date | 2024-05-31 |