| NPI | 1295118412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: GA 96721) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: OH 35.138401) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: OH 35.138401) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2023-10-09 |