NPI | 1295358034 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: TX BP20085342) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10071455) |
Enumeration Date | 2020-05-27 |
Last Update Date | 2023-05-15 |