| NPI | 1245632389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: WI 71256) |
| Additional Taxonomies | 208600000X Surgery (Licence: WI 71256-20) |
| 208600000X Surgery (Licence: CT 70057) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-09-19 |
| Last Update Date | 2023-08-15 |