| NPI | 1730407800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: SC 86792) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: OH 35.128908) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-05-13 |
| Last Update Date | 2021-11-01 |