NPI | 1477960060 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: MN 67464) |
Additional Taxonomies | 208600000X Surgery (Licence: PA MD468504) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2014-07-16 |
Last Update Date | 2023-05-02 |