NPI | 1669909255 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: AR E-15156) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 5101022979) |
Enumeration Date | 2017-05-15 |
Last Update Date | 2022-08-04 |