| NPI | 1588228308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: IL 036.169565) |
| Enumeration Date | 2019-04-26 |
| Last Update Date | 2024-10-02 |