NPI | 1619408937 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: TN 74243) |
Additional Taxonomies | 208D00000X General Practice (Licence: WA ml60781919) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-03-27 |
Last Update Date | 2025-07-28 |