NPI | 1821437344 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: CA 132067) |
Additional Taxonomies | 2086S0129X (Licence: HI MD-21954) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 193300) | |
Enumeration Date | 2013-06-18 |
Last Update Date | 2025-04-29 |