| NPI | 1649739533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 208600000X Surgery (Licence: FL UO9956) |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2024-06-26 |