NPI | 1447645221 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: MO 2021027694) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2015-03-30 |
Last Update Date | 2021-09-23 |