| NPI | 1316434541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 208600000X Surgery (Licence: AL 38699) |
| Enumeration Date | 2018-04-13 |
| Last Update Date | 2023-06-20 |