| NPI | 1366937823 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: AL DO.3238) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 5101024157) |
| Enumeration Date | 2018-06-27 |
| Last Update Date | 2023-07-16 |