| NPI | 1780107987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: FL ME164092) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: PA MD477897) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN25561) | |
| Enumeration Date | 2017-07-19 |
| Last Update Date | 2023-08-29 |