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 | 2020-10-21 |