NPI | 1376170662 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: MA 1023605) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2020-03-25 |
Last Update Date | 2025-08-05 |