| NPI | 1700140118 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN 18293) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: OH 57-000000) |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2014-05-16 |