| NPI | 1578720926 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: PA MD438340) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: VA 0116028931) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116028931) | |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2018-09-18 |