| NPI | 1891228516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: NY 317613) |
| Additional Taxonomies | 208600000X Surgery (Licence: NM 317613) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-10 |
| Last Update Date | 2023-06-05 |