| NPI | 1346432572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: MN 62506) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: TX Q1587) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-08-12 |
| Last Update Date | 2018-01-18 |