| NPI | 1770803769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CO DR.0057547) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2086S0102X Surgery Surgical Critical Care (Licence: CO DR.0057547) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL0005903) | |
| Enumeration Date | 2010-06-02 |
| Last Update Date | 2018-07-13 |