| NPI | 1699237883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: VA 0101270245) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: PA MT238408) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-04-05 |
| Last Update Date | 2026-07-06 |