| NPI | 1396131850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA a177676) |
| Additional Taxonomies | 208600000X Surgery (Licence: GU M-2371) |
| 208600000X Surgery (Licence: NY 291376) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: GU M-2371) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-11 |
| Last Update Date | 2023-10-27 |