| NPI | 1659931343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10075314) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX BP10075314) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-06-16 |
| Last Update Date | 2021-05-08 |