| NPI | 1467852137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: NC 2014-01612) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 200548) |
| Enumeration Date | 2014-08-29 |
| Last Update Date | 2014-09-09 |