| NPI | 1811251929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: OK 34201) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: CA A133698) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-07-03 |
| Last Update Date | 2022-04-11 |