| NPI | 1821382367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: LA 308673) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: TN 55111) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-06-01 |
| Last Update Date | 2022-06-28 |