| NPI | 1285009050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: PA LT000792) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY P00296) | |
| Enumeration Date | 2015-12-05 |
| Last Update Date | 2021-03-22 |