| NPI | 1851850960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: UT 14224794-1205) |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2026-04-17 |