| NPI | 1386828697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: TX Q9907) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX Q9907) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-12-21 |
| Last Update Date | 2023-07-20 |