| NPI | 1740727940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: IL 125069718) |
| Enumeration Date | 2017-01-25 |
| Last Update Date | 2022-07-21 |