| NPI | 1528122256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: MD D0089752) |
| Additional Taxonomies | 208600000X Surgery (Licence: MD D0089752) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2025-05-30 |