NPI | 1386858157 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: AL 27784) |
Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: OH 35.099572) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2007-05-10 |
Last Update Date | 2023-06-29 |