| NPI | 1821262890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: MI 4301119250) |
| Additional Taxonomies | 2086S0102X Surgery Surgical Critical Care (Licence: TN 52865) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-04-21 |
| Last Update Date | 2023-09-20 |