| NPI | 1245499896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: CA A113335) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: CA A113335) |
| 208600000X Surgery (Licence: CA A113335) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: MO 2017024332) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-06-07 |
| Last Update Date | 2024-04-29 |