NPI | 1306289871 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: KY 56173) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2013-04-15 |
Last Update Date | 2025-03-31 |