| NPI | 1326298936 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: IL 036158339) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL ME128369) |
| 208600000X Surgery (Licence: NY 255914) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: FL ME128369) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-09-19 |
| Last Update Date | 2022-05-19 |