| NPI | 1649469495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: TX R4699) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: OH 35.124410) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2022-07-18 |