| NPI | 1689846982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: KY 49898) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208600000X Surgery (Licence: KY R1952) | |
| Enumeration Date | 2008-03-26 |
| Last Update Date | 2017-04-19 |