| NPI | 1730340076 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: NC 2008-01264) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 150288) |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2010-09-07 |