| NPI | 1770895971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MD440155) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: PA MD440155) |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2010-07-06 |