| NPI | 1700318490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: OH 35.148662) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: OH 35.148662) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 63922) | |
| Enumeration Date | 2017-03-31 |
| Last Update Date | 2024-08-05 |