| NPI | 1508326752 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: GA 100170) |
| Enumeration Date | 2019-03-22 |
| Last Update Date | 2024-05-28 |