| NPI | 1891952388 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: OH 35 129410) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: CA A111684) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2023-12-04 |