| NPI | 1659726909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: AL MD.45089) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: AL MD.45089) | |
| Enumeration Date | 2016-04-24 |
| Last Update Date | 2024-06-14 |