| NPI | 1467623025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: PA MD432689) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 232111) |
| Enumeration Date | 2008-03-21 |
| Last Update Date | 2008-07-18 |