| NPI | 1649739533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: SC DO82172) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: SC DO82172) |
| 208600000X Surgery (Licence: SC DO82172) | |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2025-11-18 |