| NPI | 1730568940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CO DR.0064293) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: CO DR.0064293) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10052961) | |
| Enumeration Date | 2015-05-20 |
| Last Update Date | 2020-09-29 |