| NPI | 1659507523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: OR MD213584) |
| Additional Taxonomies | 208600000X Surgery (Licence: OR MD213584) |
| 2086S0127X Surgery, Trauma Surgery (Licence: FL ME119083) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL ME119083) | |
| Enumeration Date | 2009-06-05 |
| Last Update Date | 2023-05-09 |