| NPI | 1609167063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: UT 130847551205) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: UT 130847551205) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MI 4301099240) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301099240) | |
| Enumeration Date | 2011-04-20 |
| Last Update Date | 2023-09-05 |