NPI | 1407065477 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: NC 2013-01206) |
Additional Taxonomies | 208600000X Surgery (Licence: MI 4301089909) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301089909) | |
Enumeration Date | 2007-05-22 |
Last Update Date | 2024-08-23 |