| NPI | 1750707261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery (Licence: TN 63026) |
| Additional Taxonomies | 208600000X Surgery (Licence: TN 63026) |
| 208600000X Surgery (Licence: NE 28843) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-03-07 |
| Last Update Date | 2022-06-01 |