NPI | 1518200690 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: OH 35.134455) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2013-03-27 |
Last Update Date | 2022-01-25 |