NPI | 1275891384 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: NY 293853) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: KY 50205) |
Enumeration Date | 2012-04-26 |
Last Update Date | 2018-10-19 |