| NPI | 1306050109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: AL 27818) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: TX P5836) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2017-02-17 |