| NPI | 1598077703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL os17916) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL 17916) |
| 208600000X Surgery (Licence: OH 34.010524) | |
| 208600000X Surgery (Licence: ZZ OS17916) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 208600000X Surgery (Licence: MS 23844) | |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2024-05-06 |