| NPI | 1275971582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: CT 060416) |
| Additional Taxonomies | 208600000X Surgery (Licence: CT 060416) |
| 2086S0127X Surgery Trauma Surgery (Licence: CT 060416) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-06-08 |
| Last Update Date | 2019-10-20 |