| NPI | 1437445798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery Surgical Oncology (Licence: AZ 61662) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX R7759) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301098417) | |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2022-04-12 |