NPI | 1326434556 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: FL OS16687) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL UO3919) |
Enumeration Date | 2015-04-14 |
Last Update Date | 2020-10-20 |