NPI | 1396907432 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: CA 20A10484) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA 20A10484) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2008-06-30 |
Last Update Date | 2019-03-28 |