| NPI | 1841723616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CT 079243) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: CT 079243) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2024-11-15 |