NPI | 1477181758 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: IL na) |
Additional Taxonomies | 208600000X Surgery (Licence: WA 61070469) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2020-03-31 |
Last Update Date | 2025-07-25 |