NPI | 1568902104 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: VA 0102205372) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
208600000X Surgery (Licence: VA 0102205372) | |
Enumeration Date | 2017-03-01 |
Last Update Date | 2023-10-30 |